We help you find information on prescription drug coverage and costs.
A formulary is a list of drugs covered under your plan, with details about the type of coverage. You may hear the word "formulary" during a doctor’s visit or when you pick up a prescription.
A tier is a level of coverage. If you have a two-tier plan, you have two levels of coverage. A five-tier plan has five levels. Tier 1 drugs are generic drugs, and you pay less for these. You have a higher copay for drugs that are in higher tiers.
A closed drug list (also called a closed formulary) covers only the drugs on the list. If a drug doesn’t appear on the list, it is not covered.
An open drug list (also called an open formulary) gives some coverage to drugs that are not listed, but you will generally pay more.
Your pharmacy benefits plan includes thousands of drugs – too many to list. So your main drug list contains only the most commonly prescribed drugs.